Prison-based correctional rehabilitation: An overview of intensive interventions for moderate to high-risk offenders

Trends & Issues in Crime and Criminal Justice no.412

Foreword | Correctional rehabilitation programs are routinely offered to moderate to high-risk offenders in all Australian jurisdictions. The similarities in service provision between states and territories is great; most, if not all, offer programs that are dedicated towards reducing risk in sexual and violent offenders, as well as addressing more general causes of offending. This paper describes some of the changes that have occurred to service provision since the last national review of offenders programs was conducted in 2004. It highlights the trend towards the delivery of high intensity (greater than 100 hour face-to-face contact) programs in Australia and notes some of the differences that exist between the various jurisdictional approaches to offender rehabilitation.

These newer programs (rolled out since 2004) are of a generally high standard, are well-embedded within correctional case management systems and are consistent with evidence-based principles of offender rehabilitation. It seems likely that these programs will have a positive impact on recidivism, although rigorous evaluation of program outcomes still needs to occur.

Adam TomisonDirector

The rehabilitation of offenders in Australia

Australia's prison population continues to grow at a rate that is four times that of the general population (ABS 2009). The current imprisonment rate (170 per 100,000 population) well exceeds the rate found across Scandinavia, Western Europe, Canada, England and Wales, and New Zealand (Sarre 2009). In September 2009, there were almost 85,500 adult persons receiving correctional services in Australia, with over 30,000 (36%) people in prison (a figure that includes periodic detention).

Correctional administrators in Australia have, in recent years, invested significant resources into the development and delivery of programs (and associated policy, staff training, monitoring and evaluation) targeted at rehabilitating moderate to high-risk prisoners. These initiatives have been supported by a robust body of evidence demonstrating that rehabilitative efforts are generally successful in reducing recidivism (see Andrews & Bonta 2010). Indeed, there is some evidence to suggest that without rehabilitation, sanctions and incarceration alone may result in increased rates of reoffending (Chen & Shapiro 2007).

Prior to 2004, little information (either outcome-based or descriptive) was available about the national profile of Australian offender programs. In 2004, however, a report entitled Correctional Offender Treatment Programs: The National Picture in Australia was published by the Criminology Research Council (Howells et al. 2004). The authors concluded that while each correctional jurisdiction was implementing a range of programs on a local level, both in the community and custodial settings, and had well-developed systems of program delivery, highly motivated staff and a general organisational acceptance of the importance of offender rehabilitation, an issue of major significance was the failure of many existing programs to meet internationally accepted minimum hours requirements:

Many programs would be regarded as brief in comparison with accepted international practice, which recommends a minimum of 100 hours programme time if programmes are to achieve optimal results in terms of reductions in recidivism. Currently only a few programmes delivered in Australia would meet this minimum, and clearly, intensive programmes are more demanding of resources. The extent to which less intensive programmes currently offered can achieve strong reductions in recidivism is largely unknown (Howells et al. 2004: 85).

The information contained in this paper is drawn from a more recent and larger study (Heseltine, Sarre & Day forthcoming) which extends the work of Howells et al. (2004) by highlighting the changing trends of custodial-based offender rehabilitation programs in Australia over the last five years. It does this in two ways—first, by summarising the significant developments that have occurred in custodial-based offender treatment programs for moderate to high-risk offenders and second, by highlighting changing areas of strength and pinpointing areas for future development in relation to what are internationally accepted 'good practice' criteria.

Methodology

Data for this study were obtained from interviews with representatives (and their nominees) from each state/territory correctional administration. In addition, program information was elicited from existing documentation and program manuals supplied by each jurisdiction. Programs were included in the review if they were greater than 10 hours in duration and if they were designed to reduce the risk of recidivism. For the purposes of the current report, only the management of higher risk (violent and sexual) offenders is considered, although each jurisdiction currently offers a broader suite of offender rehabilitation programs (see Heseltine, Sarre & Day forthcoming).

Legislative framework

The legislative context for rehabilitation programs in Australia is varied and diverse. Not only are there different legislative approaches, but a variety of models also exist. These range from the virtually non-existent legislative guidance model, such as that which exists in Victoria, to a specific legislative mandate model such as the one prescribed by the ACT's Crimes (Sentence Administration) Act 2005 (which is to be read together with the provisions of the Corrections Management Act 2007). While some Australian legislation has been designed to satisfy the public's demand for intensive programming, such as exists for sexual and 'dangerous offenders', in other jurisdictions (eg South Australia) there is a very general administrative fiat, with policy specifics left principally to departmental development.

There is an apparent tension between the competing aims of correctional services and sentencing legislation; legislators want to keep some offenders out of their communities for as long as possible, while, at the same time, wanting to rehabilitate others so that they can re-enter their communities without jeopardising public safety (or, indeed, a government's 'tough on crime' credentials). It appears that those who have responsibility for the carriage of rehabilitation programs rarely refer to current legislation for guidance and that affirmations of the rehabilitative purpose in legislation are not only useful, but required.

A review of Australian programs

There is strong evidence of an ongoing commitment by correctional administrators to the development and delivery of custodial-based offender rehabilitation programs and associated models of service delivery. All jurisdictions currently deliver programs aimed at reducing the likelihood of recidivism for those offenders assessed as at high risk of committing further offences upon release from custody. At the same time, the development of high intensity programs specifically designed for women, Indigenous Australians and intellectually disabled offenders has been slower. What follows is a brief overview of the more intensive custody-based offender rehabilitation programs that are currently offered in Australia, including sex offender, violent offender and cognitive skills programs.

Motivational programs

The recent development of motivation and preparatory programs warrants special attention (see Table 1), given the high rates of attrition in some programs and emerging evidence that increasing readiness to engage in interventions has a positive effect on program completion (see Day et al. 2010). These programs typically aim to provide an introduction to group-based therapy, to improve problem awareness and increase motivation to change behaviour. In addition, 'specific relapse prevention' or 'maintenance' programs are sometimes offered after a program has been completed. Typically, these aim to reinforce skill rehearsal after program completion as well as to monitor ongoing risk and maintain motivation for offenders to lead offence-free lifestyles (Day & Casey 2010).

Table 1:Motivational/preparatory/maintenance program

Jurisdiction

Program title

Criminogenic need

Duration

Qld

Turning Point

Substance use

15 hours

Getting Started Preparatory Programme

Sex offender

33–44 hours

WA

Cognitive Brief Intervention

Cognitive skills

20 hours

Vic

Exploring Change

Substance use

12 hours

ACT

Back in Control

Substance use

32 hours

First Steps

Substance use

12 hours

NSW

The Impact of Dependence

Substance use

34 hours

Getting Smart

Substance use

24 hours

DAAP

Substance use

16 hours

Understanding Sexual Offending

Sexual offending

16 hours

PREP—Preparation for Treatment

Sexual offending

24–48 hours

Custody Based Maintenance

Sexual offending

ongoing

Tas

Preparing for Change

Substance use

24 hours

Getting SMART

Substance use

36 hours

Cognitive skills programs

Although some studies have reported significant reductions in offender recidivism following the completion of a cognitive skills program (eg see Lipsey, Landenberger & Wilson 2007), some of the early optimism regarding the efficacy of this type of program has been tempered by suggestions that program gains may not extend beyond one year and that program dropouts have higher rates of recidivism than program completers (Cann et al. 2003).

Offender treatment programs that target cognitive skills training are now a common feature (implemented or planned) in every Australian correctional management strategy (refer Table 2). What is noticeably different in the delivery of cognitive skills programs since the 2004 audit is the replacement, by most jurisdictions, of less intensive programs with programs of moderate intensity (100 hours) that are designed to meet the needs of higher risk/need offenders. Cognitive skills programs continue to be used as foundation programs, in which core skills are targeted for development during subsequent offence-focused program involvement.

Cognitive skills programs are based on the theoretical premise that offending behaviour, for some, is linked to inadequate thinking skills, such as interpersonal problem-solving, moral reasoning, cognitive style, self-control and perspective-taking. Accordingly, programs typically seek to enhance the following skills

self-control;

critical reasoning;

problem-solving;

interpersonal perspective-taking;

socio-moral decision making; and

victim awareness.

Most jurisdictions have developed detailed program manuals, which, with a few exceptions, include detailed theoretical and empirical rationales, descriptions of therapeutic principles and notes for facilitators involved with individual sessions. Similarly, the 2009 audit reveals that staff training continues to be well-developed, with national and international experts commonly utilised for the initial training and 'train the trainer' models being developed for ongoing in-house training. Evaluation of cognitive skills programs remains on the agenda for most correctional departments, with 'outcomes completed' predominately focusing on process and content. The exception is a recent evaluation in Queensland of the program known as Making Choices, which reported strong effect sizes on intermediate measures of change. Some caution needs to be taken with these findings, however, due to the small sample size. There are plans to follow-up and extend this evaluation.

Table 2:Cognitive skills programs

Jurisdiction

Program title

Type

Specific target

Duration

Risk need assessment for entry

Pre-post measures of change

Evaluation

SA

Making Choices—being developed

Vic

Maintaining Change

Maintenance

25 hours

√

Exploring Change

Motivational

12 hours

√

Cognitive Skills

Therapeutic

60 hours

√

√

Cognitive Skills

Therapeutic

Women

60 hours

√

Cognitive Skills

Therapeutic

Koori men

60 hours

√

√

Making Choices

Therapeutic

100 hours

√

√

Making Choices

Therapeutic

Women—pilot

100 hours

√

√

NSW

Think First

Therapeutic

60 hours

√

√

√

ACT

Cognitive Self Change

Therapeutic

100+ hours

√

√

Planned

Qld

Making Choices

Therapeutic

100 hours

√

√

√

Making Choices Programme

Maintenance

16–24 hours

√

√

NT

Cognitive Skills

Psycho-educational

24 Hours

√

√

Tas

Making Choices

Therapeutic

100 hours

√

Planned

WA

BOAS

Psycho-educational

Indigenous

20 hours

√

√

Planned

Cognitive Brief Intervention

Motivational

20 hours

√

Think First

Therapeutic

60 hours

√

√

√

Legal and Social Awareness

Therapeutic

Intellectually disabled

60 hours

√

Sexual offender programs

There are a number of factors, such as the introduction of dangerous offender and specific sex offending legislation, advocacy from victim support agencies and concern expressed by the community and in the media that have resulted in increased efforts to rehabilitate sexual offenders. This has led, in some jurisdictions, to the provision of dedicated funding for the delivery of sex offender rehabilitation programs.

There is a general consensus in the professional literature that sexually deviant behaviour is learned and as such, may be amenable to change (Curnow, Streker, & Williams 1998). Indeed, there is some evidence that sex offender treatment programs are effective in reducing rates of reoffending, particularly with moderate to high-risk offenders (Olver, Wong & Nicholaichuk 2009). The evidence base is less robust with regard to intellectually disabled sex offenders, with no randomised experimental evidence to guide treatment with this group (Ashman & Duggan 2004).

Australian jurisdictions routinely provide high intensity sexual offender programs for moderate to high-risk/need sexual offenders (refer to Table 3), with the primary aim of reducing the likelihood of sexual reoffending.

In keeping with principles of good practice, all jurisdictions have mechanisms to identify and refer sex offenders to programs, to assess risk of sexual offending (commonly employing reliable and valid actuarial risk assessment measures), to understand offending behaviour and to develop individual needs-based management plans.

To address the difficulty of managing offenders who categorically deny that they have offended, two jurisdictions (New South Wales and Western Australia) have developed what are referred to as 'denier's' programs. These programs aim to help offenders understand more about the context which resulted in charges being laid, as well as to help them develop a self-management plan and to avoid situations in which further accusations might arise.

In Australia, there have been only three published treatment outcome studies. The most recent was the evaluation of the Victorian Sex Offender Program (SOP; Owen et al. 2007) which reported a lower sexual recidivism rate for SOP completers (4%) than for non-completers who withdrew from the program (20%) and those who were removed from the program (10%). Given that all jurisdictions are in the process of evaluating these programs, there is a likely to be a spate of completed evaluations in the foreseeable future.

Table 3:Sex offender programs

Jurisdiction

Program title

Specific target

Duration

Risk/need assessment for entry

Pre-post

Evaluation

Vic

SOP—high intensity

180 hours

√

√

√

SOP—moderate intensity

120 hours

√

√

√

Disability Pathways

Cognitive disability

12 months

√

√

√

NT

Under review

NSW

Understanding Sexual Offending

16 hours

√

√

PREP—Preparation for Treatment

24–28 hours

√

√

CUBIT—Custody-based Intensive Treatment

240 hours

√

√

CORE

100–130 hours

√

√

CORE-low

Intellectual disability

40 hours

√

√

Deniers Program

80 hours

√

√

Self-regulation Program

Intellectual disability

300+ hours

√

√

Custody-based Maintenance

ongoing

ACT

Adult Sex Offender Programme

24 months

√

√

Planned

Qld

Getting Started Preparatory Programme

Intellectual disability

33–44 hours

√

√

Underway

High Intensity Sexual Offending Programme

Indigenous

350 hours

√

√

Underway

Inclusion Sexual Offending Programme

108 hours

√

√

Underway

Indigenous Sexual Offending Programme

78–350 hours

√

√

Underway

Moderate Intensity Sexual Offending Programme

78–132 hours

√

√

Underway

Sexual Offending Maintenance Programme

33–44 hours

√

Tas

New Directions

100–300 hours

√

√

Planned

SA

SBC

250 hours

√

√

Planned

WA

Indigenous Medium Sex Offender Program

Indigenous

120 hours

√

√

√

Intensive Program

460 hours

√

√

√

Medium Sex Offender Program

105 hours

√

√

√

Deniers Program

95 hours

√

√

√

Deniers Programme

95 hours

√

√

Ongoing

Violent offender programs

Nearly half (47%) of all sentenced prisoners are in custody for crimes of violence (AIC 2007). There has been an increased focus in recent years on the rehabilitation of high-risk violent offenders, evidenced by the delivery of programs in six jurisdictions (refer to Table 4; and plans for the development of programs in Tasmania and the Northern Territory).

Violent offender programs within Australia are underpinned by cognitive behavioural strategies and target a wide range of criminogenic needs. Violent offenders routinely undertake an offence-specific assessment to determine program suitability, typically involving a structured clinical assessment and the use of psychometric assessment tools to assess their level of risk and criminogenic need. Readiness and responsivity factors are also routinely assessed. There is, however, a paucity of published research on the efficacy of violent offender programs, both in Australia and internationally. This gap needs to be addressed as a matter of urgency.

Table 4:Violent offender programs

Jurisdiction

Program title

Duration

Risk/need assessment for entry

Pre-post test

Evaluation

NSW

VOTP —high

240 hours

√

√

√

VOTP—moderate

100–130 hours

√

√

√

VOTP—maintenance

Ongoing

√

Qld

Cognitive Self Change

100 hours

√

√

√

WA

Violent Offender Treatment Program

316 hours

√

√

√

Medium Intensity Violence

132.5 hours

√

√

√

Tas

Planned

Vic

VIP —high intensity

180 hours

√

√

√

VIP—moderate intensity

120 hours

√

√

√

ACT

Cognitive Self Change

100 hours

√

√

NT

Planned

SA

VPP

330 hours

√

√

Planned

Summary

In 2004, Howells et al. (2004) in their audit of Australian offender rehabilitation programs, called upon each jurisdiction to further develop the theoretical underpinnings of programs, develop more sophisticated assessment and selection processes, deliver programs that were better integrated with broader case management processes and increase the intensity of existing programs. Jurisdictions, almost uniformly, have responded to this challenge. They have conducted internal (and in some cases external) reviews, which have identified the need for programmatic change and developed a number of more of intensive rehabilitation programs for moderate to high-risk offenders.

These newer programs (rolled out since 2004) are of a generally high standard, are well-embedded within correctional case management systems and are consistent with evidence-based principles of offender rehabilitation (Andrews & Bonta 2010). It is likely that they will have a positive impact on recidivism rates, although there is a need to ensure that ongoing (internal and external) evaluations of program outcomes are completed. More broadly, there would appear to be a strong commitment within Australian correctional departments to rehabilitative ideals and some confidence that offender rehabilitation programs do indeed 'work'. This approach is, however, rarely endorsed in the popular media. It would appear that key stakeholders in the rehabilitative process might consider publicising the value of their programs more widely. This can be done in ways that highlight the positive contribution that correctional services departments around the country make to community safety, without jeopardising the modern political desire for governments to be seen to be 'tough on crime'.

Heseltine K, Sarre R & Day A 2011. Correctional offender treatment programs: The 2009 national picture in Australia. Research and public policy series no. 112. Canberra; Australian Institute of Criminology